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Tay SK. Improving the effectiveness of cervical cancer screening: Managing positive high-risk human papillomavirus results. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:342-351. [PMID: 38979990 DOI: 10.47102/annals-acadmedsg.2023329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Introduction Good compliance of the management of abnormal results is important for effective cervical screening. This study investigated the rate of surveillance and follow-up outcomes for human papillomavirus (HPV)-positive women in cervical screening. Method Women on surveillance by repeat HPV testing were identified in a prospectively managed database. Data retrieved included women's age, country residence status, history of colposcopy, HPV-DNA status on the first and repeat tests, dates of follow-up during the 5 years since the initial screening, and histological diagnosis of cervical lesions. The main outcome measures were compliance rate for repeat HPV testing, regression and persistence rates of HPV subtypes, and detection rate of high-grade lesions (CIN2+). Results This analysis included 680 residents in the community, mean age 44.8 (95% confidence interval 20.1-69.5) years. The compliance rate of repeat testing was 28.2% at 12 months and, cumulatively, 42.8% for the entire 5-year follow-up period. The rates were unaffected by age (P=0.5829) nor prior colposcopy (P=0.1607). There were 5 (1.7%) cases of CIN2+ detected. Of 391 women on longitudi-nal follow-up, 194 (60.8%) cleared their HPV infection. Some women with multiple HPV infection cleared 1 but not the other subtype(s). Thus, the regression rate was 90.3% for HPV-16, 87.0% for HPV-18 and 65.2% for HPV-12-others (P=0.001). The annualised HPV regression rates were similar for HPV subtypes and for each follow-up year. Conclusion Surveillance of HPV positivity is clinically important for detecting high-grade lesions. Despite a high regression rate of HPV, surveillance hesitancy is a serious weakness in routine cervical screening.
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Affiliation(s)
- Sun Kuie Tay
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
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2
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Jackman JM, Yibrehu B, Doyle A, Alatise OI, Wuraola FO, Olasehinde O, Peter Kingham T. Updates in global oncology: Advancements and future directions. J Surg Oncol 2024; 129:1374-1383. [PMID: 38624014 DOI: 10.1002/jso.27633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
Globally, cancer is the second leading cause of death, and low- and middle-income countries bear most of the disease burden. While cancer is increasingly recognized as a major global health issue, more work remains. Understanding the status of global cancer care will shape the next steps in ensuring equitable global access to cancer care. This article highlights ongoing initiatives in global oncology and the next steps in advancing the field.
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Affiliation(s)
- Julia M Jackman
- Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Betel Yibrehu
- Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Alex Doyle
- Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Caribbean Colon Cancer Initiative, Bridgetown, Barbados
| | - Olusegun Isaac Alatise
- Surgery Department, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Olalekan Olasehinde
- Surgery Department, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - T Peter Kingham
- Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Asempah E, Wiktorowicz ME. Understanding HPV Vaccination Policymaking in Rwanda: A Case of Health Prioritization and Public-Private-Partnership in a Low-Resource Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6998. [PMID: 37947556 PMCID: PMC10649882 DOI: 10.3390/ijerph20216998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Rwanda is the first African country to implement a national HPV vaccination program in 2011. This study sought to clarify the HPV vaccination policymaking process in Rwanda through the lens of Kingdon's multiple stream framework and Foucault's concept of governmentality. Perspectives of policymakers engaged in HPV vaccination policy were gathered from published sources, along with key informant interviews. Rwanda's track record of successful vaccination programs enabled by a culture of local accountability created public and private sector incentives. Effective stakeholder engagement, health priority setting, and resource mobilization garnered locally and through international development aid, reflect indicators of policy success. The national HPV policymaking process in Rwanda unfolded in a relatively cohesive and stable policy network. Although peripheral stakeholder resistance and a constrained national budget can present a threat to policy survival, the study shows that such factors as the engagement of policy entrepreneurs within a policy network, private sector incentives, and international aid were effective in ensuring policy resolution.
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Affiliation(s)
- Eric Asempah
- School of Health Policy & Management, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada;
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Waheed DEN, Bolio A, Guillaume D, Sidibe A, Morgan C, Karafillakis E, Holloway M, Van Damme P, Limaye R, Vorsters A. Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries? Front Public Health 2023; 11:1112981. [PMID: 37124764 PMCID: PMC10140426 DOI: 10.3389/fpubh.2023.1112981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/17/2023] [Indexed: 05/02/2023] Open
Abstract
Cervical cancer due to human papillomavirus (HPV) infection is a leading cause of mortality among women in low-resource settings. Many Sub-Saharan African countries have introduced HPV vaccination programs at the national level in the last few years. However, countries are struggling to maintain sustainable coverage. This study focuses on the introduction and sustainability challenges, context-specific key lessons learned, and mechanisms of action to achieve high sustainable coverage from low and lower-middle-income countries (LLMICs) that have introduced HPV vaccination programs by collating evidence from a literature review and key informant interviews. Local data availability was a challenge across countries, with the lack or absence of registries, data collection and reporting mechanisms. Multi-sectoral coordination and early involvement of key stakeholders were cited as an integral part of HPV programs and facilitators for sustainable coverage. Key informants identified periodic sensitization and training as critical due to high staff turnover. Health workforce mobilization was fundamental to ensure that the health workforce is aware of the disease etiology, eligibility requirements, and can dispel misinformation. Schools were reported to be an ideal sustainable platform for vaccination. However, this required teachers to be trained, which was often not considered in the programs. District-level staff were often poorly informed and lacked the technical and logistic capacity to support vaccination rounds and data collection. To improve the sustainability of HPV vaccination programs, there is a need for timely microplanning, efficient preparedness assessment, assessing training approaches, periodic training, finding innovative ways to achieve equity and adoption of a bottom-up approach to ensure that processes between districts and central level are well-connected and resources are distributed efficiently.
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Affiliation(s)
- Dur-E-Nayab Waheed
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Ana Bolio
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dominique Guillaume
- Jhpiego, The Johns Hopkins University Affiliate, Baltimore, MD, United States
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Anissa Sidibe
- Department of Vaccine Programmes, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Christopher Morgan
- Jhpiego, The Johns Hopkins University Affiliate, Baltimore, MD, United States
- Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Emilie Karafillakis
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Megan Holloway
- Department of Vaccine Programmes, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
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Cianci S, Tarascio M, Arcieri M, La Verde M, Martinelli C, Capozzi VA, Palmara V, Gulino F, Gueli Alletti S, Caruso G, Restaino S, Vizzielli G, Conte C, Palumbo M, Ercoli A. Post Treatment Sexual Function and Quality of Life of Patients Affected by Cervical Cancer: A Systematic Review. Medicina (B Aires) 2023; 59:medicina59040704. [PMID: 37109662 PMCID: PMC10144819 DOI: 10.3390/medicina59040704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction: The aim of this study is to analyze the available scientific evidence regarding the quality of life (QoL) and sexual function (SF) in patients affected by cervical cancer (CC) after surgical and adjuvant treatments. Materials and Methods: Preliminary research was conducted via electronic database (MEDLINE, PubMed and Cochrane Library) with the use of a combination of the following keywords: SF, QoL, and CC. The principal findings considered in the present review were the study design, the number of patients included in each study, the information about the malignancy (histology and stage of disease), the questionnaires administered, and the principal findings concerning SF and QoL. Results: All studies were published between 2003–2022. The studies selected consisted of one randomized control study, seven observational studies (three prospective series), and nine case control studies. The scores used were focused on SF, QOL, fatigue, and psychological aspects. All studies reported a decreased SF and QOL. The most developed questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Female Sexual Function Index (FSFI), the Hospital Anxiety and Depression scale (HADS), and the Female Sexual Distress Scale (FSDS). Discussion: All studies reported a decreased SF and QOL. In addition to the perception of body image, several factors coexist in influencing the outcomes such as the physical, hormonal, psychological. Conclusions: Sexual dysfunction after CC treatment has a multifactorial aetiology which negatively affects the quality of life. For these reasons, it is important to follow and support patients with a multidisciplinary team (doctors, nurses, psychologists, dieticians) before and after therapy. This type of tailored therapeutic approach should become a standard. Women should be informed about possible vaginal changes and menopausal symptoms after surgery and on the positive effects of psychological therapy.
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Affiliation(s)
- Stefano Cianci
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Mattia Tarascio
- Obstetrics and Gynecology Unit, Department of Woman and Child, Azienda Sanitaria Provinciale di Catania, 95124 Catania, Italy
| | - Martina Arcieri
- Department of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, Italy
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Marco La Verde
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Napoli, Italy
| | - Canio Martinelli
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Vittorio Palmara
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Ferdinando Gulino
- Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy
| | - Salvatore Gueli Alletti
- Obstetrics and Gynecology Unit, Department of Woman and Child, Ospedale Buccheri La Ferla Fatebenefratelli, 90123 Palermo, Italy
| | - Giuseppe Caruso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Stefano Restaino
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Giuseppe Vizzielli
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Carmine Conte
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Alfredo Ercoli
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
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Illah O, Olaitan A. Updates on HPV Vaccination. Diagnostics (Basel) 2023; 13:243. [PMID: 36673053 PMCID: PMC9857409 DOI: 10.3390/diagnostics13020243] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/11/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Cervical cancer still poses a significant global challenge. Developed countries have mitigated this challenge by the introduction of structured screening programmes and, more recently, the HPV vaccine. Countries that have successfully introduced national HPV vaccination programmes are on course for cervical cancer elimination in a few decades. In developing countries that lack structured screening and HPV vaccination programmes, cervical cancer remains a major cause of morbidity and mortality. The HPV vaccine is key to addressing the disproportionate distribution of cervical cancer incidence, with much to be gained from increasing vaccine coverage and uptake globally. This review covers the history and science of the HPV vaccine, its efficacy, effectiveness and safety, and some of the considerations and challenges posed to the achievement of global HPV vaccination coverage and the consequent elimination of cervical cancer.
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Affiliation(s)
- Ojone Illah
- Women’s Cancer Department, EGA Institute for Women’s Health, University College London, London WC1E 6BT, UK
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Mwenda V, Bor JP, Nyangasi M, Temmerman M. Mobilizing stakeholders to drive the cervical cancer elimination agenda in Kenya: The national cervical cancer stakeholders' forum 2022. DIALOGUES IN HEALTH 2022; 1:100066. [PMID: 38515876 PMCID: PMC10953883 DOI: 10.1016/j.dialog.2022.100066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 03/23/2024]
Abstract
Background Kenya is among the nineteen countries in Sub-Saharan Africa with the highest burden of cervical cancer globally. The high burden of cervical cancer in developing countries reflects the absence of effective cervical cancer prevention programs with limited resources invested to provide comprehensive services. Objective We aimed to engage stakeholders in a structured consultative forum, to gain insights and forge effective partnerships to drive the cervical cancer elimination agenda in Kenya. Methods The National Cervical Cancer Stakeholders Consultative Forum was organized as a part of activities to commemorate the National Cervical Cancer Awareness Month on 19th January 2022 in Nairobi, Kenya. The overall goal of the meeting was to provide a forum to sensitize stakeholders on the National Cervical Cancer Prevention and Control Program (NCCP) with a view to strengthen partnerships, increase coordination for improved service delivery and to provide a forum for resource mobilisation and alignment of key stakeholders towards elimination of cervical cancer in Kenya. Nominal group technique was adopted for structured discussions, and the findings analysed to derive key themes. Findings Key challenges to primary and secondary prevention of cervical cancer were identified as low awareness, stigma and misinformation, high unmet need for treatment of early lesions, few health care providers with capacity to screen and treat, inadequate supplies, inefficient health information systems and poor referral pathways. Championing integration of cervical cancer screening and treatment services into routine health programs, strengthening policy implementation and robust monitoring and evaluation were identified as critical interventions. Conclusion The National Cervical Cancer Stakeholders Forum 2022 provided insights for enabling Kenya to progress on the 2030 elimination targets. Such forums can be useful in bringing all actors together to evaluate achievements and identify opportunities for more effective national cervical cancer prevention and control programs.
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Affiliation(s)
- Valerian Mwenda
- National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Joan-Paula Bor
- National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Mary Nyangasi
- National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Marleen Temmerman
- Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Nairobi, Kenya
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Narasimhamurthy M, Kafle SU. Cervical cancer in Nepal: Current screening strategies and challenges. Front Public Health 2022; 10:980899. [PMID: 36466479 PMCID: PMC9713638 DOI: 10.3389/fpubh.2022.980899] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Nepal has a high burden of cervical cancer primarily due to a limited screening program. Most present with advanced cervical disease. Despite no national cervical cancer control program, Nepal's Ministry of Health and Population has taken many initiatives with various international collaborations in screening, vaccination, and treating pre-invasive and invasive cancer. However, the existing prevention and treatment modalities are dismally inadequate to meet the targets of WHO's cervical cancer eliminative initiative by 2030. We provide an overview of the Ministry of Health and Population, Nepal's efforts to tackle the growing cervical cancer burden in the country. We discuss the challenges and potential solutions that could be practical and augment screening uptakes, such as single-dose vaccination and HPV DNA tests. The screen-and-treat approach on the same day could potentially address treatment delays and follow-up loss after testing positive. Our narrative summary highlights existing and innovative strategies, unmet needs, and collaborations required to achieve elimination across implementation contexts.
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Affiliation(s)
- Mohan Narasimhamurthy
- Department of Pathology and Laboratory Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, United States,*Correspondence: Mohan Narasimhamurthy
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Śniadecki M, Poniewierza P, Jaworek P, Szymańczyk A, Andersson G, Stasiak M, Brzeziński M, Bońkowska M, Krajewska M, Konarzewska J, Klasa-Mazurkiewicz D, Guzik P, Wydra DG. Thousands of Women’s Lives Depend on the Improvement of Poland’s Cervical Cancer Screening and Prevention Education as Well as Better Networking Strategies Amongst Cervical Cancer Facilities. Diagnostics (Basel) 2022; 12:diagnostics12081807. [PMID: 35892517 PMCID: PMC9394414 DOI: 10.3390/diagnostics12081807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/21/2022] Open
Abstract
Proper targeted cancer prophylaxis reduces the incidence of cancer in all forms; this includes cancers with significant progression potential and poor prognosis. Based on the assumption that one of the risk factors of cervical cancer is the avoidance of screening tests, we analyzed the current scenario of cervical cancer (CC) screening and recommendations in Poland (country with a well-off socioeconomic status). Based on the comprehensive literature review concerning documents of guidelines and recommendations of various bodies, including national ones, data on the implementation of CC screening in Poland, and different models for medium-to-high-income countries, we proposed how the CC screening strategy could be improved. Finally, the new strategy was further developed for those who are prone to not being screened. The proposal on how to improve the Polish CC screening program is the following: refinement of the public education on CC risk factors, popularization of CC screening incentives amongst the public, and improvement of networking strategies between CC screening facilities (“cervical screening clinical”), allowing screenings to be more efficient and rapid. We believe that, to enhance the future quality of life of those with rapid CC progression by catching the disease preemptively and limiting the sequelae of the disease, we have to improve education and access to medical services.
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Affiliation(s)
- Marcin Śniadecki
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
- Correspondence: ; Tel.: +48-501-337-941
| | | | - Paulina Jaworek
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Ada Szymańczyk
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Gorm Andersson
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Maria Stasiak
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Michał Brzeziński
- Department of Gynecologic Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland;
| | - Małgorzata Bońkowska
- Emergency Department, University Clinical Center in Gdańsk, 80-952 Gdańsk, Poland;
| | - Magdalena Krajewska
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Joanna Konarzewska
- Department of Radiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Dagmara Klasa-Mazurkiewicz
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Paweł Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital Rzeszów, 35-241 Rzeszów, Poland;
| | - Dariusz Grzegorz Wydra
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
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10
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Yang M, Du J, Lu H, Xiang F, Mei H, Xiao H. Global trends and age-specific incidence and mortality of cervical cancer from 1990 to 2019: an international comparative study based on the Global Burden of Disease. BMJ Open 2022; 12:e055470. [PMID: 35868828 PMCID: PMC9316042 DOI: 10.1136/bmjopen-2021-055470] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe the trends of incidence and mortality of cervical cancer in different age groups and regions from 1990 to 2019. DESIGN An international comparative study based on the Global Burden of Disease (GBD) study estimates. PARTICIPANTS Data were publicly available and individuals were not involved. METHODS We collected detailed information on cervical cancer from the GBD study between 1990 and 2019. Average annual percentage changes (AAPCs) of age-standardised incidence and mortality rate (ASIR and ASMR) in cervical cancer, by age group and region, were calculated to quantify the temporal trends. RESULTS Globally, the absolute numbers of incident cases and deaths were increasing, with the most cervical cancer cases and deaths being reported in China, India and Brazil. Although the ASIR and ASMR have declined overall from 1990 to 2019, an increasing or stable trend was also observed in East Asia and Southern sub-Saharan Africa. Particularly, we found that the age-specific AAPC of incidence showed an increasing trend in the age group of 15-49 years globally, and the high Sociodemographic Index region increased the most. CONCLUSIONS Cervical cancer remains a concerning disease that affects women all over the world, although the ASIR and ASMR are decreasing. Efforts to control the younger trend and to reduce the disparity between regions are imminent.
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Affiliation(s)
- Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
| | - Juan Du
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
| | - Hui Lu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
| | - Feiyan Xiang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
| | - Hong Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
| | - Han Xiao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Institute of Maternal and Child Health, Wuhan, Hubei, China
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Ahuja M, Sharma P, Sarkar A. Universal Cervical Cancer Immunization: India Ready for a Quantum Leap. J Midlife Health 2022; 13:260-262. [PMID: 36950205 PMCID: PMC10025827 DOI: 10.4103/jmh.jmh_224_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 01/28/2023] Open
Affiliation(s)
- Maninder Ahuja
- Director, Ahuja Health Care Services, ESIC Medical College, Faridabad, Haryana, India
| | - Priyanka Sharma
- Department of Obstetrics and Gynaecology, ESIC Medical College, Faridabad, Haryana, India
| | - Avir Sarkar
- Department of Obstetrics and Gynaecology, ESIC Medical College, Faridabad, Haryana, India
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12
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Song L, Liu S, Zhao S. Everolimus (RAD001) combined with programmed death-1 (PD-1) blockade enhances radiosensitivity of cervical cancer and programmed death-ligand 1 (PD-L1) expression by blocking the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR)/S6 kinase 1 (S6K1) pathway. Bioengineered 2022; 13:11240-11257. [PMID: 35485300 PMCID: PMC9208494 DOI: 10.1080/21655979.2022.2064205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cervical cancer (CC) is the 4th most prevalent malignancy in females. This study explored the mechanism of everolimus (RAD001) combined with programmed death-1 (PD-1) blockade on radiosensitivity by phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway and autophagy in CC cells. Low-radiosensitive CaSki cells were selected as study objects. After RAD001 treatment, PI3K/AKT/mTOR pathway activation, autophagy, migration and invasion abilities, autophagy-related proteins (LC3-I, LC3-II, and p62), and PD-L1 expression in CC cells were detected. After triple treatment of radiotherapy (RT), RAD001, and PD-1 blockade to the CC mouse models, tumor weight and volume were recorded. Ki67 expression, the number of CD8 + T cells, and the ability to produce IFN-γ and TNF-α in tumor tissues were determined. RAD001 promoted autophagy by repressing PI3K/AKT/mTOR pathway, augmented RT-induced apoptosis, and weakened migration and invasion, thereby increasing CC cell radiosensitivity. RAD001 elevated RT-induced PD-L1 level. RT combined with RAD001 and PD-1 blockade intensified the inhibitory effect of RT on tumor growth, reduced the amount of Ki67-positive cells, enhanced radiosensitivity of CC mice, and increased the quantity and killing ability of CD8 + T cells. Briefly, RAD001 combined with PD-1 blockade increases radiosensitivity of CC by impeding the PI3K/AKT/mTOR pathway and potentiating cell autophagy.
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Affiliation(s)
- Lili Song
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shikai Liu
- Department of Obstetrics and Gynecology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Sufen Zhao
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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13
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Taylor AC, Hopkins LW, Moore G. Increasing human papillomavirus immunization in the primary care setting. Nurse Pract 2021; 46:37-42. [PMID: 34554962 DOI: 10.1097/01.npr.0000790528.06533.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Human papillomavirus (HPV) is a leading cause of cancer. Increasing HPV vaccination recommendations by primary care providers to patients decreases the burden of this viral infection. Providers need to be educated about this condition and the available options for immunization to feel confident in making strong recommendations and thereby increase HPV immunization rates.
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